How to Survive a Panic Attack

Panic attacks come in all forms, all of which suck tremendously. They can be brought on by specific triggers or seemingly come out of nowhere with no rhyme or reason. They can vary from feeling like you're dying to getting the shakes to anything in between. How are you to deal with these potentially debilitating moments when time seems to freeze, the world disappears around you, and all you know is the all-encompassing feeling of your panic?

From personal experiences to research I've explored during my own navigation through panic hell, I'm going to share with you some tips I've learned along the way in coping with panic. Attacks have surprised me with aching chest pains that hurt so much I thought I was having a heart attack, (which, of course, doesn't help the panic), shortness of breath, shakiness, faintness, dizziness, chills, hot flashes, nausea, gut pain, and sometimes sobbing uncontrollably while gasping for air. In such moments, there are a few techniques that I resort to in order to relieve the consuming symptoms. Here we go:

1. Stop. I definitely have to sit down or step away. Sometimes, if the situation allows, I rush outside to get a breath of fresh air. 

2. This brings me to a hugely beneficial coping technique and that is breathing. Ever heard of belly breathing? It's when you put one hand on your belly and one hand on your heart. Breathe in for four seconds, filling your belly so that it expands outward like a baby's belly does, hold it for two seconds, then breathe out deeply emptying your belly and chest of air. Repeat. I usually have to close my eyes to do this in an attempt to shut out the external stimuli.

3. Being mindful of your breathing is another mode of calming down. What this means is only to focus on your breath: Where is it coming in? How does it feel? What does it sound like? Where does it flow to in your body? How does it feel as it exits your body?

4. When I feel a panic attack approaching, I admittedly do reach for the occasional Xanax; however, when I want to avoid relying on the medicine, (because eventually it loses its potency if we take it too often), I resort to essential oils. Aromatherapy is another form of breathing, really, except now you have something pretty to smell. I've noticed that peppermint and lavender are incredibly helpful when I need to calm down. These can be purchased at most health food stores or vitamin shops and aren't very expensive. There's another company I like to use for my essential oils called doTERRA, which can be found at http://do-essential-oils.com/. They are quite expensive, but their essential oil blends are so amazingly relaxing. I use their PastTense Tension Blend and ClaryCalm, and they help tremendously in taking the edge off.

5. Water is another natural substance we can use in helping calm the rush of nerves. Drinking cool water, splashing water on your face, or making a wet, cold compress to lay on the back of your neck or forehead can soothe the mind and body. 

6. You wouldn't think movement would help when your heart rate is already elevated, but in many cases, taking a walk can calm the anxiety and clear your mind.

7. Progressive muscle relaxation is another suggestion. You start with your toes, contract them, hold for 5 seconds, then release. You do this with each isolated muscle group as you move up your body.

8. Preparation or having "safety blankets" provides a sense of security that can greatly aid you in the midst of panic. For me, my sense of security involves me always having a bottle of water handy, mints or hard candy to calm me, along with my appropriate medication. Simply knowing that I have my "safety blankets" helps to alleviate the onset of an impending attack or alleviate the attack itself.

Mind you, these tips are coping mechanisms to use in those desperate moments of a panic attack, but there are things we can do to prevent these attacks from happening in the first place. Practicing meditation, mindfulness, and yoga are instrumental in developing a sense of inner peace. Therapy and medication if needed and prescribed your physician helps in managing the anxiety. Exercise and eating healthy keeps your body and thus your mind strong. Most importantly, self-care needs to be a priority. Taking care of yourself is not selfish; it is self-preservation and is absolutely necessary. These practices probably won't dissolve your anxiety completely, nor will they make all of your panic disappear overnight; however, if you make a habit of finding what works for you and using it, the better you can manage and alleviate your anxiety and panic.

http://www.huffingtonpost.co.uk/maria-senise/panic-attack-how-to-cope_b_5519446.html

8 Things To Understand About Panic Attacks & How To Deal With Them

 

I remember my first panic attack in more detail than I remember losing my virginity or the first time I drove a car by myself. (I guess vivid terror of suddenly not being able to breathe really ingrains itself into your psyche.) It was 1998 and I was watching the “Psycho” remake with my family’s French exchange student. During the infamous shower scene, my throat and lungs tightened inside me like a figure eight knot.  I got up and paced around the movie theater, unable to control my body and wondering if I was having a heart attack. I’ve had panic attacks periodically since then, probably due to a combination of biology and circumstance. I’ve made an effort to lessen the conditions that they occur in and for the most part, I live a pretty calm life. My anxiety only spikes in extreme circumstances, such as the rare times I’ve gotten temporarily stuck in a subway underground (I’m claustrophobic).

After a couple of years without anxiety attacks in my everyday life, I’ve started having them again. The stress is related to old stuff resurfacing in my life and the anxiety is pretty much the same, too: my chest tightens, my heart beats too fast, I can’t breathe, and I feel like I’m having a heart attack. (Or, you know, what I assume a heart attack feels like.) I’m 30 now. Panic attacks are still shitty and frustrating, but all the experience I’ve had coaxing myself through them over the years actually does makes them less intense and quicker to get over.

These are my thoughts on what panic attacks are like, how to deal with them, and what I hope other people could understand if they’re trying to help:

1. Panic attacks are really fucking scary. If a person is panic attack virgin, his or her mind naturally goes to an Oh my God I’m dying I need to get the ER!!! place.  That’s … a bad place. Yet, it’s a deeply-ingrained reaction to feeling physically out of control. (Google “flight or fight response.”) All you’re feeling while you’re having one is that you would give anything to feel normal again — panic attacks are so scary that I used to have panic attacks because I was worried about having panic attacks!

The reality is that after the person calms down and starts breathing normally again, he or see will feel better soon. “Better,” of course, is relative, but what I mean is that when she calms down, she’ll be able to see that she’s not immediately at risk. In the moment, though, her focus is on her inability to breathe, tense muscles, dizziness, trembling and her wildly-beating heart. She feels like she could be dying and is rightfully terrified.

So, if someone you know is having an anxiety attack, be sensitive. It’s an enormously scary thing to go through. Make them feel safe and keep calm yourself.

2. Anxiety isn’t necessarily rational, so explaining why not to panic isn’t helpful. Conquering an anxiety attack is a matter of “mind over body,” but that doesn’t mean the panic is just going to shut itself off when the person hyperventilating into a paper bag hears a really good argument. People mean well. I get it. But something that always frustrates me is when my family or friends try to rationalize why I shouldn’t be having an anxiety attack. Like, I’m in therapy, I’m an self-reflective person, I know I shouldn’t be hyperventilating over XYZ problem. Alas, my anxiety doesn’t respond to logic — it responds to feelings. So, in the throes of a panic attack, try not to address their problems. Instead, focus on making this person feel safe and staying calm. (By all means, address their problems later, though.)  

3. A panic attack might be tipped off to something specific, but it usually has been built up over time. Here are a few things that have caused me to have panic attacks:

- a combinatronics test

-an email from my mother

- the death scene in documentary about John Lennon

Were those really the stressors that made me have an anxiety attack? No, of course not. They were just what triggered a well of worry and anxiety to rise up and spill over. This is part of the reason why I say that anxiety isn’t rational; coaxing a person to respond to the immediate trigger is sort of useless. Stress is much wider and deeper than it seems on the visible surface.

4.  Medication generally works for me, but dealing with anxiety has a lot more to do with practicing self-care. I have a prescription for Lexapro and also Xanax. So, yes, I am an advocate  of addressing generalized anxiety disorder (GAD) and depression through proper medication. That being said, there are no quick fixes. I believe what has really helped me the best — the real reason that I went several years without large panic attacks — was because I made well-rounded self-care my #1 priority. What does that mean? I get eight to 10 hours of sleep every night. I don’t over-commit myself to plans or responsibilities. I use the word “no.” I try to eat healthy-ish. I go to the gym a couple times a week. I don’t take hard drugs and I barely drink. And I stay as far away from stress-producing assholes and energy vampires as possible. (I’m personally not a fan of the “just meditate!” or “just do yoga!” schools of anxiety remediation, but lots of people say that works for them.)

5. Avoiding anxiety triggers is also important. The phrase “trigger warning” gets used a lot in feminist activism and academia (lately, often times in a denigrating way). Personally, I don’t go around telling other people what they shouldn’t expose me to and instead worry about what I expose me to. I know I’m not awesome in tiny, compact spaces, such as airplanes. I get really anxious when people are murdered in movies. A few years ago, I stumbled across a man domestically abusing a woman on my street and, quite understandably, I had a panic attack. So, when I can control it, I try not to expose myself to stressful triggers. (Conversely, if I start to feel panicky, I’ll do things that have proven to make myself calmer, like going outside for fresh air or giving my husband a call.)

6.  Panic attacks are embarrassing.  Everyone experiences stress. But anxiety attacks really are a physical manifestation of how you’re feeling inside and, to be frank, that can feel like you’re weak and whiny. Most people don’t want to think that way about themselves. And it’s really hard for some people to admit weakness, especially if they put up a front of toughness. It took me years — like almost a decade — to get past my denial and embarrassment over feeling depressed and anxious. I prided myself on being successful and put-together; I didn’t want my peers to think I was weak or “crazy.” I thought if I hid how I felt, eventually it would change on its own. Well … if anything was crazy, it was that idea.

7.  A lot of times anxiety goes hand-in-hand with depression.  A lot of people, especially women, experience anxiety and depression together. Just like I take care of my anxiety, I have to take care of my depression, too. Again, it’s not really a big deal in my life because I generally take care of it well.  I try to make smart choices for my life while keeping everything in mind — for example, I don’t drink much, because alcohol is a depressant.

8. Some medical professionals really fucking suck at helping with anxiety. I once saw an (old, white, male) GP who advised me to cope with my anxiety attacks by keeping a paper bag in my purse and breathing into it. The doctor meant well. But his “advice”? It was crap. He made me feel like I had been overreacting and just being silly. This was during one of my worst bouts of panic attacks  during college, which eventually lead me to getting prescribed Lexapro and seeing my therapist again.  I wish I had gotten a second opinion, because I suffered for something like seven or eight months absolutely vicious panic attacks until I actually got help. All that time was wasted just because I didn’t have someone who knew what he was talking about.  So try to be as patient as you can. You deserve good help. When you’ve gotten it, your anxiety will become manageable and your life become enjoyable again. Not to co-opt It Gets Better but … it does get better.

http://www.thefrisky.com/2014-06-25/8-things-to-understand-about-panic-attacks-how-to-deal-with-them/

Panic Disorder Treatment

                                                                         Introduction

Panic attacks and panic disorder can be very disabling conditions for the people who suffer from them. Sometimes they can lead to avoidance of any activity or environment which has been associated with feelings of panic in the past. This can in turn lead to more severe and disabling disorders such as agoraphobia.

Panic attacks typically begin in young adulthood, but can occur at any time during an adult's life. A panic episode usually begins abruptly, without warning, and peaks in about 10 minutes. It can last anywhere from a few minutes to a half hour or longer. Panic attacks are characterized by a rapid heart beat, sweating, trembling, and a shortness of breath. Other symptoms can include chills, hot flashes, nausea, cramps, chest pain, tightness in the throad, trouble swallowing and diziness.

Women are more likely than men to have panic attacks. Many researchers believe the body's natural fight-or-flight response to danger is involved. For example, if a grizzly bear came after you, your body would react instinctively. Your heart and breathing would speed up as your body readied itself for a life-threatening situation. Many of the same reactions occur in a panic attack. No obvious stressor is present, but something trips the body's alarm system.

Treatment emphasizing a three-pronged approach is most effective in helping people overcome this disorder: education, psychotherapy and medication.

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Psychotherapy

Education is usually the first factor in psychotherapy treatment of this disorder. The patient can be instructed about the body's "fight-or-flight" response and the associated physiological sensations. Learning to recognize and identify such sensations is usually an important initial step toward treatment of panic disorder. Individual psychotherapy is usually the preferred modality and its length is generally short-term, under 12 sessions. An emphasis on education, support, and the teaching of more effective coping strategies are usually the primary foci of therapy. Family therapy is usually unnecessary and inappropriate.

Therapy can also teach relaxation and imagery techniques. These can be used during a panic attack to decrease immediate physiological distress and the accompanying emotional fears. Discussion of the client's irrational fears (usually of dying, passing out, becoming embarrassed) during an attack is appropriate and often beneficial in the context of a supportive therapeutic relationship. A cognitive or rational-emotive approach in this area is best. A behavioral approach emphasizing graduated exposure to panic-inducing situations is most-often associated with related anxiety disorders, such as agoraphobia or social phobia. It may or may not be appropriate as a treatment approach, depending upon the client's specific issues.

Group therapy can often be used just as effectively to teach relaxation and related skills. Psychoeducational groups in this area are often beneficial. Biofeedback, a specific technique which allows the client to receive either audio or visual feedback about their body's physiological responses while learning relaxation skills, is also an appropriate psychotherapeutic intervention.

All relaxation skills and assignments taught in therapy session must be reinforced by daily exercises on the patient's part. This cannot be emphasized enough. If the client is unable or unwilling to complete daily homework assignments in practicing specific relaxation or imagery skills, then therapy emphasizing such skill sets will likely be unsuccessful or less successful. This pro-active approach to change (and the expectations of the therapist that the client will agree to this approach) needs to be clearly explained at the onset of therapy. Discussing these expectations clearly up-front makes the success of such techniques much greater.

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Medications

A lot of people who suffer from panic disorder can successfully be treated without resorting to the use of any medication. However, when medication is needed, the most commonly-prescribed class of drugs for panic disorders are the benzodiazepines (such as clonazepam and alprazolam) and the SSRI antidepressants. It is rarely appropriate to provide medication treatment alone, without the use of psychotherapy to help educate and change the patient's behaviors related to their association of certain physiological sensations with fear.

Phillip W. Long, M.D. notes that, "Clonazepam (Klonopin, Rivotril) and alprazolam (Xanax), are the treatment of choice in the treatment of Panic Disorder. Clonazepam and alprazolam are preferred to antidepressant drugs because of their less severe side effects." He also states that it is preferred to try the anti-anxiety agents before moving on to the antidepressants because of the increased side-effect profiles. Xanax can be addicting for individuals and should be used with care. Treatment with either clonazepam or alprazolam should be discontinued by tapering it off slowly, because of the possibility of seizures with abrupt discontinuation.

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Self-Help

Self-help methods for the treatment of this disorder are often overlooked by the medical profession because very few professionals are involved in them. Many support groups exist within communities throughout the world which are devoted to helping individuals with this disorder share their commons experiences and feelings.

Patients can be encouraged to try out new coping skills and relaxation skills with people they meet within support groups. They can be an important part of expanding the individual's skill set and develop new, healthier social relationships.

http://psychcentral.com/disorders/sx28t.htm